Arizona funeral homes have delayed burials and cremations, and some say they can't take in any more bodies, amid a bureaucratic logjam caused bythe bumpy rollout of a new state database of births and deaths.

The Arizona Department of Health Services went live with its new database Oct. 2, seeking to streamline how doctors, medical examiners and funeral directors submit and process records — things like death certificates and disposition permits that allow them to do their work on behalf of grieving families.

Maricopa County officials said the switch has been riddled with confusion, frustration and technical glitches, forcing some funeral directors to delay processing the deceased, according to emails obtained by The Arizona Republic.

"We're only one week into this, and we've already added to the grief of hundreds of families, and cost tens of thousands of dollars in time for us, for you, for funeral homes and for providers," Dr. Bob England, director of the Maricopa County Department of Public Health, said in an Oct. 8 email to ADHS officials. "This is not what I signed up to do, and we cannot continue this much longer."

In a follow-up email the next day, England warned ADHS Director Cara Christ: "My biggest concern to date is the unknown number of families that have had to postpone services in their time of grief.

"Dr. Johnston’s (our Medical Examiner) biggest fear is that as funeral homes exceed storage capacity, we may already be on the verge of needing to activate the mass fatality plan, to include using refrigerator truck storage in the vacant lot across the street from the OME (Office of the Medical Examiner)," he continued. "That would be highly visible. We’ll be wheeling bodies back and forth across 8th Ave, need to re-route the Juror Parking, and it will become a national news story."

The Arizona Department of Health Services has launched an emergency-operations center and the Maricopa County Department of Public Health has assigned extra staffers to work overtime and on weekends to try to resolve the backup.

The scope of the problem is in dispute, however.

ADHS executives, who also are trying to assess the scope of the funeral-home bottleneck, said they so far have found only six out of 183 Arizona funeral homes at capacity and 12 families that experienced delays involving a dead loved one.

State health department officials have called each funeral home every day since Wednesday. Also, the state has called every county health department, but only Maricopa County reported concerns about the new database, according to Christ.

A more limited survey completed Tuesday by Maricopa County found more than 200 delayed burials and cremations, and that 20 of 54 funeral homes were not accepting new bodies. As of that day, funeral homes were receiving three bodies for every corpse they were about to process after obtaining proper permits, according to county officials.

State officials hope to ease a slowdown in burials and cremations by putting extra workers on duty to help with technical glitches and training problems related to a new death-records database.(Photo: Nick Oza/The Republic)

'We knew there were some issues'

Christ acknowledged there have been challenges. State health-department staffers have been assigned as liaisons to every funeral home to help with problems or delays those businesses are experiencing.

"You know there are going to be bumps with a new IT (information technology) system," Christ said. "We knew there were some issues. The vendors have responded very quickly."

Families experiencing delays involving a loved one can call 602-542-1025 or visit azhealth.gov for help.

The new database, called the Database Application for Vital Events, or D.A.V. E., is a computerized system that replaced the older computer-and-paper hybrid system used to order death certificates and permits for burials and cremations.

State officials said they sought the new system to make it easier for people to order vital records, including birth and death certificates. The plan is to allow the vital records to be ordered online rather than in person at a government office.

But the switch to the new system also required changes in how funeral homes processed the deceased; how doctors signed off on death certificates; and how funeral homes obtained permits for burials and cremations.

The old system allowed doctors to fax a brief, one-page document on cause of death to the funeral home. Maricopa County would assign staffers to help funeral homes gather key information, fill out documents and obtain "disposition" permits allowing burials and cremations, officials said. This could be done before a formal death certificate was in hand.

Under the new system, funeral homes are required to first obtain a death certificate before completing other records for burials and cremations.

Counties also have not been able to access computerized records until all other stakeholders have completed their records, which means funeral homes can no longer receive help from county staffers to fill out key documents.

Doctors who certify death certificates also must log onto the database and fill out 30 to 40 information fields. About 2,600 doctors were automatically loaded into the database, but those doctors were required to log onto the database and change their passwords. State health officials also have reached out to another 1,300 medical providers who certify death certificates to try to ensure there are no barriers to processing records.

State health officials chose not to require mandatory training for doctors because they did not want to overwhelm the busy professionals. Other training options, such as webinars, were offered.

While ADHS said the system was tested by various parties before the Oct. 2 launch, the agency decided against a trial run with funeral homes before the official launch due to the technical challenges of running two systems.

Encouraging the doctors to use the database and obtaining proper disposition permits are among changes that created a bottleneck at funeral homes in Maricopa County, according to county health officials.

England, who advocated for a practice run or a phased rollout of the new system, urged Christ and other state health-department staffers earlier this week to activate an emergency-operations center.

State health-department officials said they have responded to concerns raised in Maricopa County and other counties. The state has agreed to temporarily allow Maricopa, Pima and Cochise counties to use paper records to obtain permits — similar to the old system — allowing funeral homes to arrange burials and cremations.

State health officials noted that the old system had its problems, too. State law requires a medical provider to certify cause of death within 72 hours and register a death within seven days. But under the old system, about half of death certificates were not completed within the seven-day window required by state law, according to Colby Bower, a state health-department assistant director.

'Nothing short of a chaotic mess'

Several funeral homes in the state have expressed frustration with the switch to the new system.

"It's been nothing short of a chaotic mess," said Mark Vining, owner of Vining Funeral Home in Safford. "The state wasn't prepared."

Vining said mock funerals with empty caskets or urns have been held in Arizona when funeral homes have not been able to obtain timely burial or cremation disposition permits.

He noted that funeral homes are not required under state law to have refrigeration, and he worries what could happen if some homes can't get the proper permits to dispose of the bodies.

Sam Bueler, funeral director of Wyman Cremation and Burial Chapel in Mesa, said the state's training for funeral directors, doctors and others has been inadequate.

The state health department held online training sessions such as webinars and hands-on training sessions on Sept. 11.

"There were a lot of concerns from funeral directors across the state," Bueler said.

Obtaining a death certificate before a disposition permit has been particularly challenging with grieving families that don't necessarily have all the information at their fingertips, according to Bueler.

"People are upset, and we're the punching bag," he said. "The state has put us in a bad spot. We have to explain why their system is not working."

Counties also are assessing the financial impact of the switch to the database. Counties collect fees from issuing birth and death certificates. Those fees pay the salaries of employees who work in county vital-statistics departments. It’s unknown how much funding counties stand to lose as more consumers order these vital records online.

Last year, Maricopa County collected $3.3 million in death-certificate fees, and the county returned $800,000 in fees to the state health department, according to Maricopa County officials.

State health officials have pledged to reimburse counties for fees they may no longer collect under the switch to the online system.

England said the state's decision this week to temporarily allow medical providers to certify a cause of death using paper records and faxes has helped ease potential problems that busy physicians faced.

England said in his Oct. 9 email to ADHS that the cost of the glitches to government, private funeral homes, health-care providers and "crematories that have had to go to 24-h(our) schedules to try to catch up … must be well over 6 figures already."

He added that both his staff and ADHS officials have worked tirelessly over the past two weeks to resolve technical problems.

Though officials say the bottleneck is easing, it was unclear when the system will be operating smoothly and the backlog eliminated.

"This isn’t about state and county disagreeing on stuff, it is about people getting served when they need it," England said.